Individual provider Active NPI

Cristal Grijalva, NP

  • Family Nurse Practitioner
  • Selma, CA
National Provider Identifier
1184174765
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005157 Issued in CA
Practice address
1141 Rose Ave
Selma, CA 93662-3241
Phone
(559) 856-6310
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005157 CA Primary

Addresses

Primary practice location

1141 Rose Ave
Selma, CA 93662-3241

Mailing address

840 E Palm Dr
Hanford, CA 93230-2315
Phone (559) 904-3860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161128000748 CA Practitioner - Nurse Practitioner 0941589477 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Nov 1, 2016 Accepting new patients
Cep America - California Current Accepting new patients
Cep America-California CurrentSince Nov 1, 2016 Accepting new patients
Central Coast Urgent Care Inc CurrentSince Sep 2, 2017 Accepting new patients
Eric N Sorensen M.D. Inc. Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1028 N Douty St
Ste B
Hanford, CA 93230
Phone (559) 589-6420

1028 N Douty St
Hanford, CA 93230
Phone (559) 530-2526

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1141 Rose Ave
Selma, CA 93662
Phone (559) 790-2800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1184174765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E PALM DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932302315",
            "telephone_number": "559-904-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 ROSE AVE",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623241",
            "telephone_number": "559-856-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIJALVA",
        "first_name": "CRISTAL",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, CA

Sources for this page

Verify at the official NPI Registry.